Field Investigator- SIU

At Windhaven Insurance we are always looking for A-players who want a challenge. Are you a driven person who wants to achieve great feats of growth in an environment that feels more like a successful start-up than an insurance company? Then you might be a future Windy.

We are building the team to take Windhaven™ Insurance to the next level and we are committed to our mission, culture, data-driven decision making, and entrepreneurship.

The SIU Investigator is a full-time position in our Special Investigation Unit open to those candidates with 5+ years of insurance P&C claim adjusting experience.  The candidate will assist in identifying suspected fraud claims, reviewing claim documents, developing and recommending investigative actions, and performing all field follow-up investigation. The SIU division encompasses complex claims investigations, suspicious and fraudulent claims investigation, reports to and coordination with law enforcement or state fraud bureaus for regulatory compliance and criminal prosecutions, and corporate investigations. The SIU Investigator also conducts training sessions for adjusters, supervisors and other staff on anti-fraud and claim related topics.  

Responsibilities:

• Field investigation on suspected fraud cases
• Investigative consulting on designated SIU client claim files
• Conduct Fraud Awareness training for client offices
• Assist with presentations of potential criminal cases to DA/DOI
• Conduct Examinations Under Oath, clinic inspections, etc. in effort to fight fraud
• Traveling in local region will be up to 70%.

Qualifications and Requirements: 

• 5+ years insurance claims experience, with special consideration given to those with field adjusting experience in Auto Liability or PIP and Home Owner areas.  Previous SIU experience is a plus
• Ability to review and analyze medical reports, identify suspected fraud
• Experience in investigation of home owner claims is a must
• Strong interpersonal skills, including significant interviewing experience to take in-depth and detailed recorded and written statements
• Strong computer skills using Word, Excel, Power Point and Outlook. Ability to learn new software
• Bachelor’s degree preferred
• Substantial insurance industry SIU and technical insurance investigative experience may be substituted for the formal education requirement

Windhaven Insurance is an Equal Opportunity Employer